Psychological factors associated with distress and wellbeing in dystonia

Gowling, Helen and Eccles, Fiona (2020) Psychological factors associated with distress and wellbeing in dystonia. PhD thesis, Lancaster University.

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Abstract

This thesis examines the psychological factors involved in distress and wellbeing for people living with dystonia. Section one reports on a systematic literature review of quantitative studies examining the relationship between psychological factors and anxiety and depression in dystonia. A systematic search using key words relating to dystonia and concepts of psychological distress was conducted on four academic databases. Findings suggest that a number of psychological factors were related to anxiety and depression in dystonia. These included body concept, coping, personality traits, self-esteem, psychosocial domains of quality of life, and somatic complaints. The limited number of papers suggests that psychological factors are an under researched area when understanding the distress experienced in dystonia; nonetheless, the findings support a biopsychosocial model of understanding. This has clinical implications for the psychological management of distress for those living with dystonia and future research should seek to expand on this knowledge. Section two reports on an empirical study examining the role of coping strategies in the relationship between stigma and psychological wellbeing in people living with cervical dystonia. Individuals with cervical dystonia completed an online survey including measures of stigma, coping strategies, quality of life, psychological distress and wellbeing. A series of parallel mediation models were conducted to explore the relationships between stigma, coping strategies and distress and wellbeing. Findings indicated that maladaptive coping strategies mediated the relationship between stigma and psychological distress and wellbeing. Adaptive coping strategies did not mediate the relationship between stigma and psychological distress and wellbeing. These findings support the need for holistic psychological formulations for individuals with cervical dystonia who are also experiencing psychological distress. Section three includes the critical appraisal which reflected on the process of conducting this project. It discusses key decision points and critically evaluates some of the decisions made.